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Persistent symptoms significantly impairing quality of life also warrant medication review

Logistic regression analysis was conducted to assess the association between treatment group and achievement of 10% weight loss

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For strength training: Increase protein to 1.6-2.0g per kg body weight Add 15-25g carbs post-workout for recovery Monitor energy levels and adjust accordingly For cardio exercise: Focus on pre-workout carbs (15-30g) for energy Ensure adequate overall calories to support both exercise and medication effects Post-workout protein remains important for muscle recovery Watch for these warning signs: Excessive fatigue during or after workouts Inability to complete usual exercise intensity Prolonged muscle soreness or poor recovery Dizziness or weakness during exercise These often indicate you need more total calories or better macro distribution around your workouts

The standard protocol is to start semaglutide first, allow 4 to 6 weeks of adjustment, and then introduce keto